INFERTILITY / IVF TALK

My Infertility Journal, Part 3: From “Not Enough” to Too Many

Megan Tansom | May 15, 2019

Journal Entry from 10/30/2015:

So on to our second IUI attempt with the new doc (#5 overall). Before this, we did the letrozole and trigger shot but found out during the process that I had almost too many good-sized follicles that there was a possibility of stimulating too many eggs.

SIDE NOTE… Follicles (as in ovarian follicles) are little fluid-filled sacs that contain oocytes (your immature eggs). When the follicle grows to a certain size, it will rupture and release a mature egg to be fertilized. When fertility medications are taken during the IUI or IVF process, ovaries are stimulated to produce more follicles than the typical one that is produced naturally per month. Learn more about follicles and the role they play in this great article here.

The nurse informed me that if we went ahead with the IUI that we would have to be OK with the possibility of multi-fetal reduction if more than three eggs would be fertilized or would “take” in her words – meaning if we became pregnant with triplets or more. What!?

I didn’t even know this was a thing. They recommended we do not move forward with more than three babies (based on my size and just safety of me and the babies) if this were to happen. We would have to “reduce” the amount of embryos if it came to that. No. I don’t want to deal with that right now! Infertility and this process are enough. One moral or physical issue at a time, please!?

IUI: Intrauterine insemination (IUI) is a fertility treatment that involves placing sperm inside a woman’s uterus to facilitate fertilization. The goal of IUI is to increase the number of sperm that reach the fallopian tubes and subsequently increase the chance of fertilization. (American Pregnancy Association). Learn more about the technical aspects of an IUI here.

 

Letrozole: Sold under the brand name Femara, letrozole was originally created to treat breast cancer. However, doctors found that it also induces ovulation, so, since 2000, it has been used off-label to help women with fertility issues. When you take the drug, it stops androgens in your body from converting into estrogen. When estrogen is blocked, the pituitary gland gets a message that it needs to produce follicle-stimulating hormone (FSH), which stimulates the ovary to produce an egg. Some women on letrozole actually release more than one egg because they produce more FSH while on letrozole than a woman produces when ovulating naturally. (Today’s Parent). Learn more about Letrozole here.

 

Trigger shot: The placenta produces human chorionic gonadotropin, or hCG, during pregnancy to increase the lining of your uterus so your baby can implant there. It is also responsible for producing progesterone, which will eventually take over the job of maintaining the lining of your uterus. HCG also has properties that trigger your ovaries to release eggs, thus the name “trigger shot” for an injection of the synthetic form of this hormone that will prompt ovulation. (Livestrong). Learn more here.

 

Multi-fetal reduction: A surgery called multifetal reduction lowers the number of fetuses and improves your chances for a healthy pregnancy. Learn more on WebMD here.

The nurse told me to take the night to discuss with Ryan but we had to decide as time is everything in this process and we had to move forward quickly if we wanted to go ahead with this cycle. We of course have already done the monitoring (ultrasounds) and medications for this round so all that was left was the procedure. On one hand, I was so excited about how my ovaries and follicles responded, and on the other hand, it was devastating because it feels like we went from not enough to too many. Why does this happen?

I immediately burst into tears in my car in the parking lot. I called Ryan and tried to explain over the phone. He had an immediate response (of course) but we decided to discuss more at home after work. Yes, I was on my way to work again. I looked up multi-fetal reduction and any statistics I could find that day. The nurse had said it was EXTREMELY unlikely this would happen, but we had to be aware just in case. That gave me a little comfort. Bottom line is that when you are going through this struggle, canceling one cycle is heartbreaking and especially when I had such a “good” response. I contemplated internally all day.

I remember thinking about it on my drive home that night and getting lost in thoughts and scenarios. Then when I stopped at a stop sign, I listened briefly to the song on the radio that had been distant in my thoughts. I for some reason really listened into the lyrics and tears streamed down my face. You guys, I REALLY am not a crier… like had a marathon of sad movies in high school with my girlfriends to see if I had a soul. They bawled. I laughed at them. This though, this journey was an emotional one. Anyway, the main chorus of “Fly” by Maddie and Tae is just what I needed to hear at that moment in time. Cheesy, but true.

So keep on climbing, though the ground might shake
Just keep on reaching though the limb might break
We’ve come this far, don’t you be scared now
‘Cause you can learn to fly on the way down

 

Searching for a sign in the night even like a lonely string of lights
That’ll burn just long enough for you to see it
The road’s been long and lonely and you feel like giving up
There’s more to this than just the breath you’re breathing

 

So keep on climbing, though the ground might shake
Just keep on reaching though the limb might break
We’ve come this far, don’t you be scared now
‘Cause you can learn to fly on the way down

 

On the way down

 

You won’t forget the heavy steps it took to let it go
Close your eyes, count to ten, hold your breath and fly

We had to believe or trust that God wouldn’t give us any more than we could handle and just let go…. and fly. We went ahead with the procedure and thought we for sure would get pregnant. I mean, there were SO MANY follicles. We prayed for one or two to take and not more. This was our best chance, right? This had to be it…

REFLECTION TODAY: Even though this was a shorter journal entry, it really got me thinking AND researching more on what we went through. First of all, I am in SUCH a different state of mind now than when I wrote that. I was essentially an emotional wreck. We were so deep into our infertility struggles I am not sure I was thinking too clearly. I would have been destroyed if we actually had to go through a multi-fetal reduction procedure. I didn’t have ALL the facts. I really didn’t even know what it meant. I think the nurses tried to explain it to me but I was so shocked by the news I didn’t listen to the gravity of it. I wish I would have had someone that had gone through this explain to me what it all meant.

We moved forward with the procedure because of the MONEY, energy, and TIME we spent that month on preparations. We moved forward because we wanted a baby so badly. We moved forward because I couldn’t fathom not trying. I couldn’t fathom canceling a chance we had. But was it really the right choice? I don’t think so anymore. It was the choice we made in the moment but that moment (and lots of moments in our infertility journey) was clouded by so much… our sadness, our will to have a baby, our determination… and not saying that in a positive way. I had a goal and I was going to achieve it no matter the cost. Looking back, I am grateful this round didn’t work. (I am grateful for all of these procedures not working as we have the children we are meant to have now… but that is for a later post). Just like I say almost daily about parenthood – we have to give ourselves a break, give ourselves some grace and realize that maybe not everything we decided at the time was the best choice looking back, but it was the best we could do at the time. I just wish I would have had someone to talk through these situations with who had been there, done that. I really didn’t know anyone at the time going through this struggle or fertility treatments so it was just me, Ryan, and Google.

I am not sure in what capacity I want to help others in their struggles. I am not sure if “coaching” or “mentoring” are even the right terms. I don’t want someone going through infertility treatments to have to PAY me for advice when they are already paying enough for these procedures and for professional advice. So right now, I am just sharing my story and hoping you/they can get insight from it. I am also researching how it could be possible for fertility clinics to provide this type of resource or community. I will keep you updated on this. I do feel as though more and more people are sharing their stories so hopefully if you are going through it right now, you are not alone. Please reach out to me if you want to chat. megan@megantansom.com. 

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